FORM 1023-EZ for BLAZE FOOTBALL INCORPORATED

Field Data
EIN 82-4388603
Case Number EO-2018060-000193
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLAZE FOOTBALL INCORPORATED
Organization’s Mailing Address 146 RICHARD ST
City BELLEVILLE
State WI
ZIP 53508
Accounting period End 12
Primary contact name ATTORNEY KJERSTEN B BAKKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEENA HIRSCHFIELD
PRESIDENT
146 RICHARD ST
BELLEVILLE WI 53508

Officer/Director/Trustee Two

JAMIE SUCHOMEL
VICE PRESIDENT
3133 S SEMINOLE HWY APT 3
FITCHBURG WI 53711-5010

Officer/Director/Trustee Three

JANET TAGGART
SECRETARY
2830 NO OAKS RIDGE
FITCHBURG WI 53711-5906

Officer/Director/Trustee Four

KJERSTEN BAKKE
COUNSEL
2830 NO OAKS RIDGE
FITCHBURG WI 53711-5906

Organization’s website WWW.MADISONBLAZEFOOTBALL.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KJERSTEN BAKKE
Signature Title COUNSEL
Signature Date 2/27/18

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